Iwamoto Junichi, Murakami Masashi, Konishi Naoki, Monma Tadakuni, Ueda Hajime, Yara Shoichiro, Hirayama Takeshi, Ikegami Tadashi, Honda Akira, Matsuzaki Yasushi
Department of Gastroenterology, Tokyo Medical University Ibaraki Medical Center, Japan.
Intern Med. 2018 Feb 1;57(3):339-342. doi: 10.2169/internalmedicine.9322-17. Epub 2017 Nov 1.
A 66-year-old Japanese male with a history of Behçet disease exhibited oral and genital ulcers, and a round deep ileocecal ulcer. He was treated with a combination of mesalazine and 20 mg/day of prednisolone (PSL), but was only partially responsive to PSL and we were not able to reduce the steroid dosage. Adalimumab was also administered. However, the ulcer was not completely responsive, and weaning the patient off PSL remained impossible. In contrast, additional treatment with clarithromycin completely healed the refractory active ulcer and left only a scar. Furthermore, the ulcer has since maintained the scar stage despite successfully weaning the patient from PSL.
一名66岁有白塞病病史的日本男性出现口腔和生殖器溃疡，以及一个圆形深部回盲部溃疡。他接受了美沙拉嗪和每日20毫克泼尼松龙（PSL）的联合治疗，但仅对PSL有部分反应，且我们无法减少类固醇剂量。还使用了阿达木单抗。然而，溃疡并未完全愈合，让患者停用PSL仍然不可能。相比之下，加用克拉霉素的额外治疗使难治性活动性溃疡完全愈合，仅留下瘢痕。此外，尽管已成功让患者停用PSL，但溃疡此后一直维持在瘢痕阶段。
